Computer-assisted optimization of aminophylline therapy in the emergency department

• HIT Description: Computerized decision support with guidelines. More info...
  
• Purpose of Study: Assess computer-guided decision support of intravenous aminophylline administration.
  
• Years of study: Not Available
  
• Study Design: RCT
  
• Outcomes: Impact on patient safety, Impact on health care effectivness/quality
  

• Settings: 82 patients requiring intravenous aminophylline from an emergency department (ED) participated in the study.
• Intervention: Patients receiving intravenous aminophylline according to population-based ED guidelines (group 1) were compared to patients receiving intravenous aminophylline according to Bayesian-derived pharmacokinetic estimates (group 2).
• Evaluation Method: Measures of aminophylline's maintenance, serum concentrations, and flow rates.
• Quality of Care and Patient Safety Outcome: The aminophylline maintenance infusion was significantly (P less than .001) lower in group 1 (0.4 +/- 0.2 mg/kg/h) than in group 2 (0.6 +/- 0.2 mg/kg/h). Serum theophylline concentrations at one hour post-loading-dose did not differ significantly between treatment groups; however, significant differences were observed at two hours post-load (P less than .002) and four hours post-load (P less than .001). Baseline peak flow rate (PFR) was significantly (P less than .03) higher in group 1 (170 +/- 85 L/min) than in group 2 (132 +/- 62 L/min), but did not differ significantly at any other times throughout the study. The PFR one hour post-load (PFR-1) was the strongest (P less than .003) predictor of outcome.